Provider Demographics
NPI:1437808169
Name:DYE, KELSI BREANNE
Entity type:Individual
Prefix:MISS
First Name:KELSI
Middle Name:BREANNE
Last Name:DYE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5475 CANNON CT APT F
Mailing Address - Street 2:
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47803-4268
Mailing Address - Country:US
Mailing Address - Phone:765-438-5937
Mailing Address - Fax:
Practice Address - Street 1:1050 W JOHNSON DR
Practice Address - Street 2:
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47802-5508
Practice Address - Country:US
Practice Address - Phone:812-233-8833
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-21
Last Update Date:2022-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst